In vitro functional comparison of therapeutically relevant human vasculogenic progenitor cells used for cardiac cell therapy  Yan Zhang, MD, MSc, Serena Wong, BSc, Jessica Laflèche, BSc, Suzanne Crowe, Thierry G. Mesana, MD, PhD, Erik J. Suuronen, PhD, Marc Ruel, MD, MPH  The Journal of Thoracic and Cardiovascular Surgery  Volume 140, Issue 1, Pages 216-224.e4 (July 2010) DOI: 10.1016/j.jtcvs.2009.11.016 Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Hurdles in cardiac cell therapy. AMI, Acute myocardial infarction. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 216-224.e4DOI: (10.1016/j.jtcvs.2009.11.016) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, The number of pooled–derived CD133+ cells (derived serially) was significantly greater than that of derived CD133+ cells (after 14 days of culture). ∗P < .05 versus fresh CD133+ cells; ^P < .05 versus derived CD133+ cells. B, The presence of a peripheral blood mononuclear cell (PB-MNC) supernatant or CD133+ cells (from whole PB-MNCs) inhibited the generation of CD133+ cells from the CD133− fraction compared with normal expansion conditions (Control). ∗P < .003 versus control. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 216-224.e4DOI: (10.1016/j.jtcvs.2009.11.016) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 A, The average number per field of view of migrating cells for the 6 progenitor populations. ∗P < .001 versus all other cell populations. PB, Peripheral blood; BM, bone marrow; EPC, endothelial progenitor cell; MSC, mesenchymal stem cell. B, The number per high-powered field of migrating CD133+ cells (fresh or derived) with CD133− cells or its supernatant after 24hours of culture. ∗P ≤ .005 versus CD133+ cells alone; ^P < .05 versus incubation with CD133− cells. C, Relative expression of selected cytokines and growth factors (normalized to control values for each cytokine). ∗P < .005 versus control media; ^P < .05 versus supernatant of fresh CD133+ peripheral blood cells; #P < .05 versus supernatant of derived CD133+ peripheral blood cells. GRO, Growth-related oncogene; IL, interleukin; MCP-1, monocyte chemoattractant protein 1; MIP-1beta, macrophage inflammatory protein 1β; RANTES, regulated upon activation normal T cell expressed and secreted; NAP-2, neutrophil-activating protein 2. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 216-224.e4DOI: (10.1016/j.jtcvs.2009.11.016) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 A–H, Representative images of the contribution of progenitor cells (red) to the formation of capillary structures with human umbilical vein endothelial cells (HUVECs): A, HUVECs alone (control); B, fresh CD133+ peripheral blood (PB) cells; C, fresh CD133+ bone marrow (BM) cells; D, PB “classical” endothelial progenitor cells (EPCs); E, BM mesenchymal stem cells (MSCs); F, BM-MSCs with DAPI-stained HUVECs; G, derived CD133+ PB cells; and H, pooled–derived CD133+ PB cells. Scale bar=150 μm. I, Average complete area of tubule structure formation with different progenitor cell populations. Derived and pooled–derived CD133+ PB cells had significantly greater capillary formation compared with fresh CD133+ from PB (∗P ≤ .007), MSCs from BM (^P < .001), and control HUVECs (#P < .05). J, Derived and pooled–derived CD133+ progenitors and fresh CD133+ PB cells had significantly greater complete tube length formation compared with control values. ∗P < .01 versus control; ■P < .001 versus all cell populations. K, Derived CD133+ progenitors had the greatest physical contribution compared with all groups except the pooled–derived CD133+ cells. ■P < .001 versus derived and pooled–derived CD133+ PB cells. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 216-224.e4DOI: (10.1016/j.jtcvs.2009.11.016) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Cell expansion. A, Representative flow cytometric analysis for coexpression of CD34 and vascular endothelial growth factor receptor 2 (VEGFR-2) on fresh and serially derived CD133+ cells collected every 2 days for a period of 8 days. PE, Phycoerythrin; FITC, fluorescein isothiocyanate. B, Flow cytometric results showing the percentage of CD133+ cells also expressing CD34 and VEGFR-2 over 8 days. C, Cumulative number of generated CD133+ cells removed every 2 days from the serial culture of the CD133− fraction of peripheral blood mononuclear cells. ∗P < .001 for day 8 versus other times. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 216-224.e4DOI: (10.1016/j.jtcvs.2009.11.016) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Cell migration. A–F, The migration properties of 6 cell populations Cell migration. A–F, The migration properties of 6 cell populations. Representative migration assay images of fresh CD133+ peripheral blood (PB) cells (A), fresh CD133+ bone marrow (BM) cells (B), PB “classical” endothelial progenitor cells (C), BM mesenchymal stem cells (D), derived CD133+ PB cells (E), and pooled–derived CD133+ PB cells (F) are shown. G–I, Cell interaction effects on CD133+ cell migration. Representative migration assay images of derived CD133+ cells alone (G), derived CD133+ cells with CD133− cells (H), and derived CD133+ cells with CD133− cell supernatant (I) after 24 hours of culture are shown. Scale bar=75 μm. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 216-224.e4DOI: (10.1016/j.jtcvs.2009.11.016) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

Mechanisms involved in the migration improvement by cell interactions Mechanisms involved in the migration improvement by cell interactions. A, Expression of vascular endothelial growth factor receptor 2 (VEGFR-2) on fresh or derived CD133+ cells cultured with or without CD133− cells for 24 hours. ∗P < .05. B–F, Representative cytokine/growth factor array images of cytokine/growth factor map of array membrane (B), culture medium only (C), CD133− peripheral blood (PB) cell supernatant after 24 hours of incubation (D), fresh CD133+ PB cell supernatant after 24 hours of incubation (E), and derived CD133+ PB cell supernatant (F) after 24 hours of incubation are shown. Pos, Positive; Neg, negative; ENA-78, epithelial cell–derived neutrophil-activating protein-78; GCSF, granulocyte colony-stimulating factor; GM-CSF, granulocyte–macrophage colony-stimulating factor; GRO, growth-related oncogene; I-309, a small glycoprotein secreted by activated T-cells; IL, interleukin; IFN, interferon; MCP, monocyte chemoattractant protein; MCSF, macrophage colony-stimulating factor; MDC, macrophage-derived chemokine; MIG, monokine induced by gamma interferon; MIP, macrophage inflammatory protein; RANTES, regulated upon activation normal T cell expressed and secreted; SCF, stem cell factor; SDF, stromal cell–derived factor; TARC, thymus and activation-regulated chemokine; TGF, transforming growth factor; TNF, tumor necrosis factor; EGF, epidermal growth factor; IGF, insulin-like growth factor; VEGF, vascular endothelial growth factor; PDGF, platelet-derived growth factor; BDNF, brain-derived neurotrophic factor; BLC, B-lymphocyte chemoattractant; FGF, fibroblast growth factor; GCP, granulocyte chemotactic protein; GDNF, glial cell line–derived neurotrophic factor; HGF, hepatocyte growth factor; IGFBP, insulin-like growth factor–binding protein; IP-10, interferon-inducible protein 10; LIF, leukemia inhibitory factor; LIGHT, lymphotoxin-related inducible ligand that competes for glycoprotein D binding to herpes virus entry mediator on T-cells; MIF, macrophage migration inhibitory factor; NAP, neutrophil-activating protein; NT, neurotrophic factor; PARC, pulmonary and activation-regulated chemokine; PIGF, placental growth factor; TIMP, tissue inhibitor of metalloproteinases. The Journal of Thoracic and Cardiovascular Surgery 2010 140, 216-224.e4DOI: (10.1016/j.jtcvs.2009.11.016) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions